A number of healthcare commentators are calling for ‘compensation’ for donors.

There are currently over 123,000 people in the US on the organ donation waiting list. Only 29,000 organ transplants took place in 2013 – a consequence of the dire shortage of organ donors.

A number of healthcare commentators are now calling for ‘compensation’ for donors.

Sally Satel of the American Enterprise Institute believes that some form of monetary incentive is the only way to address the donor shortage: “altruism, as a strategy, is simply not producing enough organs. It needs to be supplemented with compensated donation”.

Alan Langnas of the University of Nebraska and Daniel R. Solomon of the Scripps Research Institute make a similar argument.

“Organ donors, and in particular the live kidney donor, are being asked to altruistically support a system with sizable financial costs to themselves. These costs represent a considerable disincentive to organ donation. To begin to move the dial on this we must engage in a process of identifying and removing those disincentives.”

They argue that the government should pay for the lost wages of the donor and perhaps even their future medical insurance.

But could ‘compensation’ lead eventually to an organ market? And are we overlooking a deeper problem in the organ transplant process?

Dr. Jeremy Chapman of Sydney’s Westmead Hospital argues that the US is better off fixing problems in the current system, rather than abandoning altruism as a basis for donation:

“[Many] ignore the hundreds of donated kidneys that must be discarded each year in the United States. They ignore the lessons that can be learned from the successful organ procurement regions of the country that derive twice as many organs per capita as the least successful programs.”

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Xavier Symons
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Xavier Symons

Xavier Symons is a bioethicist and scholar in residence at the Kennedy Institute for Ethics at Georgetown University.

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